PROJECT SUMMARY/ABSTRACT Patients with lung cancer, the most prevalent cancer in United States affecting both men and women, experience more debilitating physical and psychological symptoms than patients with other types of cancer. Common symptoms include reduced lung function, dyspnea, fatigue, sleep disturbances, and depression compromising their quality of life (QOL). In light of these symptoms, patients have a high need for care and support. Patients? family caregivers are their most important and valued source of support and care; yet, caregiving is physically and emotionally taxing. In fact, family caregivers report high rates of psychological distress, fatigue, and sleep disturbances, which may compromise the quality of care they are able to provide to the patient. Given the interdependent nature of QOL in families, poor caregiver QOL may undermine patient QOL. Therefore, there is a need to established evidence-based dyadic supportive care programs targeting both patient and caregiver outcomes. Based on the promising findings of our pilot data, we proposed to examine a dyadic yoga program in patients with lung cancer (LC) and their family caregivers. To determine efficacy of a yoga program, the proposed research will randomly assign patient-caregiver dyads to either a dyadic yoga or a dyadic education group. Prior to randomization, both patients and caregivers will complete standard QOL measures. We will also collect biomarkers from blood and saliva samples. Patients will complete objective measures of physical performance. Based on their group assignment, dyads will either attend yoga sessions or health education sessions together. Both groups will receive the same intervention exposure (15 sessions, 60 min each) over the course of patients? 6-week radiation treatment (RT) plans. During the treatment period, we will weekly assess patients? symptoms. At the end of RT, 1, 2, 3, and 6-months later, dyads in both groups will be re-assessed. At the 3-month follow-up assessment, we will also collect qualitative samples to further understand participants? experiences. The primary goal of this research is to demonstrate that, in the yoga group, patients will show better objective physical performance both patients and caregivers will report greater improvements in QOL compared to those in the dyadic education group. Secondary goals are to examine improvements in symptom burden, endocrine and immune dysregulation and symptom management and if these improvements mediate the physical function and QOL outcomes. Lastly, we examine factors that may moderate interventions effects, which will inform future studies expanding this program of research. This project represents a major step towards managing physical performance and QOL in lung cancer patients and their caregivers, a vulnerable yet understudied population.